PMID: 8595793Aug 1, 1995Paper

Prognosis and risk stratification after myocardial infarction

European Heart Journal
G BreithardtL Reinhardt

Abstract

In order to assess prognosis after myocardial infarction, various methods have been used: estimation of ejection fraction, Holter monitoring, detection of ventricular late potentials using signal-averaging techniques, programmed ventricular stimulation of the heart to test the inducibility of ventricular tachyarrhythmias, and parameters that assess heart rate variability. Left ventricular dysfunction is the major determinant for prognosis after myocardial infarction, but left ventricular end-systolic volume may be better than overall ejection fraction. The presence of an 'arrhythmogenic substrate' may be detected by recording low-amplitude, fractionated activity or by artificially introducing premature ventricular extrasystoles using programmed ventricular stimulation. The signal-averaged ECG represents an independent tool for risk assessment. In some studies, signal-averaging and programmed ventricular stimulation proved to be more sensitive for the prediction of sustained ventricular tachycardia than for sudden death. The risk of an arrhythmic event in patients with an abnormal signal-averaged ECG or an abnormal result of programmed ventricular stimulation is increased, although the majority of these patients still do not exp...Continue Reading

Citations

Feb 1, 1997·Clinical Cardiology·J Kautzner, A J Camm
Sep 1, 1997·Herzschrittmachertherapie & Elektrophysiologie·P Weismüller
Dec 1, 1997·Herzschrittmachertherapie & Elektrophysiologie·P SteinbiglerG Steinbeck
Dec 10, 1999·Pacing and Clinical Electrophysiology : PACE·P SteinbiglerG Steinbeck
Jun 16, 2007·European Journal of Heart Failure·Antoni Bayes-GenisUNKNOWN MUSIC Study Group
Jun 11, 1999·The American Journal of Cardiology·P KääpäM Ahotupa

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